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HelpTest ID MEVP Methemoglobinemia Evaluation
Useful For
Diagnosis of methemoglobinemia and sulfhemoglobinemia and possible hereditary (congenital) causes
Differentiation of methemoglobinemia and sulfhemoglobinemia from other causes of cyanosis (eg, congenital heart disease)
Special Instructions
Method Name
MEV: Consultative Interpretation
A2F: Cation Exchange/High-Performance Liquid Chromatography (HPLC)
HBEL: Capillary Electrophoresis
METH, SULF: Spectrophotometry (SP)
METR: Kinetic Spectrophotometry (KS)
MASS: Mass Spectrometry (MS)
IEF: Electrophoresis
HPFH: Flow Cytometry
UNHB: Isopropanol and Heat Stability
MEVA: Consultative Interpretation
Reporting Name
Methemoglobinemia EvaluationSpecimen Type
Whole Blood ACD-BWhole Blood EDTA
Shipping Instructions
Specimen must arrive within 3 days (72 hours) of draw.
Necessary Information
Include recent transfusion information.
Include most recent CBC results.
Specimen Required
Both ACD-B and EDTA blood are required.
Container/Tube: Lavender top (EDTA) and yellow top (ACD [Solution B])
Specimen Volume:
EDTA: Two 4-mL tubes
ACD: One 6-mL tube
Collection Instructions: Send specimens in original tube. Do not aliquot.
Specimen Minimum Volume
EDTA Blood: 3 mL; ACD Blood: 2.7 mL
Specimen Stability Information
| Specimen Type | Temperature | Time | Special Container |
|---|---|---|---|
| Whole Blood ACD-B | Refrigerated | 72 hours | |
| Whole Blood EDTA | Refrigerated | 72 hours |
Reference Values
Definitive results and an interpretive report will be provided.
Day(s) and Time(s) Performed
Monday through Saturday
Performing Laboratory
Mayo Clinic Laboratories in Rochester
CPT Code Information
Methemoglobinemia Evaluation
82657-Methemoglobin reductase
83020-Hemoglobin electrophoresis
83021-Hemoglobin A2 and F
83050-Methemoglobin, quantitative
83060-Sulfhemoglobin, quantitative
IEF Confirms
82664-Isoelectric focusing (if appropriate)
Hemoglobin, Unstable, Blood
83068 (if appropriate)
Hemoglobin Variant by Mass Spectrometry (MS), Blood
83789 (if appropriate)
Hemoglobin F, Red Cell Distribution, Blood
88184 (if appropriate)
LOINC Code Information
| Test ID | Test Order Name | Order LOINC Value |
|---|---|---|
| MEVP | Methemoglobinemia Evaluation | In Process |
| Result ID | Test Result Name | Result LOINC Value |
|---|---|---|
| 8268 | Methemoglobin, B | 2614-6 |
| 9322 | Methemoglobin Reductase, B | 32703-1 |
| 8272 | Sulfhemoglobin, B | 4685-4 |
| 2381 | Hemoglobin A2 | 42245-1 |
| 2380 | Hemoglobin A | 20572-4 |
| 586 | Methemoglobinemia Interpretation | 59465-5 |
| 2383 | Variant | 32017-6 |
| 2382 | Hemoglobin F | 42246-9 |
| 29224 | Variant 2 | 32017-6 |
| 29225 | Variant 3 | 32017-6 |
| 2101 | Interpretation | 78748-1 |
Test Classification
See Individual Test IDsProfile Information
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| MEV | Methemoglobinemia Interpretation | No | Yes |
| A2F | Hemoglobin A2 and F | No | Yes |
| HBEL | Hemoglobin Electrophoresis, B | No | Yes |
| METH | Methemoglobin, B | Yes, (Order MET) | Yes |
| SULF | Sulfhemoglobin, B | Yes, (Order MET) | Yes |
| METR | Methemoglobin Reductase, B | Yes | Yes |
Reflex Tests
| Test ID | Reporting Name | Available Separately | Always Performed |
|---|---|---|---|
| SDEX | Hemoglobin S, Scrn, B | Yes | No |
| IEF | IEF Confirms | No | No |
| MASS | Hb Variant by Mass Spec, B | No | No |
| UNHB | Unstable Hemoglobin, B | No | No |
| HPFH | Hemoglobin F, Red Cell Distrib, B | No | No |
| ATHAL | Alpha-Globin Gene Analysis | Yes | No |
| WASQR | Alpha Globin Gene Sequencing, B | Yes, (Order WASEQ) | No |
| WBSQR | Beta Globin Gene Sequencing, B | Yes, (Order WBSEQ) | No |
| WBDDR | Beta Globin Cluster Locus Del/Dup,B | Yes, (Order WBDD) | No |
| MEVA | Methemoglobin Summary Interp | No | No |
| WGSQR | Gamma Globin Full Gene Sequencing | No | No |
Testing Algorithm
This is a consultative evaluation in which the case will be evaluated at Mayo Clinic Laboratories, the appropriate tests performed at an additional charge, and the results interpreted. This is an evaluation for methemoglobin and sulfhemoglobin levels and possible hereditary causes. Methemoglobin, sulfhemoglobin levels, methemoglobin reductase (cytochrome-b5 reductase) activity and protein analysis screening for hemoglobin variants (cation exchange HPLC and capillary electrophoresis) will always be performed. If additional hemoglobin variant confirmatory testing is required, appropriate reflex testing will be performed. This will vary from additional protein analysis methods to molecular testing, as needed.
MEVA / Methemoglobin Summary Interpretation, an additional consultative interpretation that summarizes all testing, will be provided after additional testing is completed if any of the following molecular tests are reflexed on the MEVP / Methemoglobinemia Evaluation:
-ATHAL / Alpha-Globin Gene Analysis
-WASQR / Alpha-Globin Gene Sequencing, Blood
-WBSQR / Beta-Globin Gene Sequencing, Blood
-WBDDR / Beta-Globin Cluster Locus Deletion/Duplication, Blood
-WGSQR / Gamma-Globin Full Gene Sequencing
See Benign Hematology Evaluation Comparison in Special Instructions.
NY State Approved
YesForms
1. New York Clients-Informed consent is required. Document on the request form or electronic order that a copy is on file. The following documents are available in Special Instructions:
-Informed Consent for Genetic Testing (T576)
-Informed Consent for Genetic Testing-Spanish (T826)
2. Metabolic Hematology Patient Information (T810) is available in Special Instructions
3. If not ordering electronically, complete, print, and send a Benign Hematology Test Request (T755) with the specimen.